Tooth Removal
Oral Surgery for Tooth Extraction
Why might I need to have a tooth extraction?
Tooth extractions are incredibly common procedures. It should be reiterated that an extraction is used as a procedure of last resort, when nothing more can be done to save the tooth.
Deep decay – This is easily the most common reason for tooth removal, accounting for around two-thirds of all extraction procedures performed. When decay affects the surface of the tooth as well as the pulp, root canal procedures cannot be performed. Root canal therapy is only viable where the general structure of the tooth is in stable condition.
Extra teeth –There are a variety of explanations associated with extra teeth, but most commonly they are baby teeth that do not shed. Extra teeth take up space on the arch, causing nearby teeth to twist out of place. A tooth extraction is necessary in this case to provide enough space for the teeth to properly realign.
Periodontal disease – Often teeth have to be extracted because the gums and underlying bone are so severely eroded that they can no longer hold the tooth in place securely. The cause of bone and gum recession is almost always advanced periodontal disease (gum disease). Poor bone density means that the chance of restoring the natural tooth is minimal.
Fractured teeth – Fortunately, dentists are able to save injured teeth in most circumstances with the aid of root canal therapy. However, there are some instances where the tooth has become fractured in a way that makes repair impossible. Your oral health professional will remove the tooth and use a prosthetic replacement in most cases.
How is the extraction procedure performed?
Generally, tooth extraction can be simple in nature or involve more complex surgical processes. Simple extractions are performed on fully emerged teeth after applying local anesthetic to the treatment site. Instruments are used to elevate the tooth and then sever the periodontal ligament. The tooth is then carefully removed with dental forceps.
Surgical extractions are performed on teeth that are either invisible or inaccessible, like un-erupted wisdom teeth. An incision is usually made in the gum tissue and a drill is used to precisely remove some of the adjacent bone tissue. Sometimes, the tooth has to be split into several pieces to completely remove it.
Bone grafting, or socket preservation is the placement of bone immediately after a tooth removal to preserve the bone where the tooth was removed, as well maintain bone structure and integrity around the adjacent teeth. The bone can be made of synthetic material, bone from other animals (porcine or bovine), or human bone.
Soft Tissue Grafting, or gum grafting is a procedure completed weeks prior to implant placement to help build a foundation to maintain bone mass and prevent future gum recession. This decreases the risk of implant failure, as well as prevents complications associated with exposed dental implants. The graft can be made of synthetic material, porcine or bovine, or human (derived from your own palate)
Sinus Bump/Lift also called sinus augmentation, is a procedure that makes it easier to place dental implants. This procedure increases the amount of bone in the upper jaw that is required for dental implants. This is one of the most common bone grafting procedures for dental implant patients. This procedure is generally completed at the time of implant placement, however in some cases additional bone may be required.
Plasma Rich Fibrin (PRF), is a procedure performed the day of a scheduled surgical procedure where the patient’s blood is collected into vials (phlebotomy) and placed into a centrifuge where it is spun and separated into components which are then used and combined with bone grafting or tissue grafting materials. PRF has been used in oral surgery as a barrier between tissues to prevent healing by a long junctional epithelium. It has also been used to avoid damage of gingival tissues during surgery with bone grafting, and accelerate soft tissue healing.